Recently, Senators Jerry Moran (R-KS), Amy Klobuchar (D-MN), Susan Collins (R-ME) and Heidi Heitkamp (D-ND) introduced the S. 616, the Conrad State 30 and Physician Access Act, which changes many immigration rules for foreign-born physicians. Nearly 27 percent of residents and fellows and 25 percent of all practicing physicians in the United States are foreign-born. This new bill can help reduce the physician shortage, particularly for medically underserved communities, by improving current immigration rules for these physicians. To increase retention of foreign-born physicians trained in the U.S., the bill proposes new, far-reaching changes which include:
- Exemption of national interest waiver physicians from green card numerical limits. Under current law, physicians can get a green card under the national interest waiver EB-2 category if they serve for 5 years in a medically underserved area or VA medical facility. However, these physicians are subject to the worldwide annual limit of green cards available in this category. For India- or China-born physicians, the wait for the green card can span over five years. The new bill would exempt these physicians from the worldwide cap, allowing approval of the green card once the physician completes his five-year service.
- Clarification of certain provisions of the National Interest Waiver (NIW) Green Card Clarification. The proposed bill makes clear that:
- Specialists are eligible.
- Physicians who work in locations that are not designated underserved areas to qualify for the NIW so long as certain patient based is served.
- The 5 years of required service starts when the doctor begins employment in the approved location, not when the initial green card application is filed.
- The 5 years of required service can include service during residency or fellowship training.
- The physician is not required to submit a new 5 year employment contract if he or she has already served some part of the five-year required service.
- A new petition is not required if the physician changes work location.
- Clarificationthat foreign medical degrees qualify as a member of the professions holding and advanced degree or its equivalent for the purposes of the EB-2 green card category.
- Removal of non-immigrant intent requirement for J-1 visas. Physicians who apply for a J-1 visa to enter a residency or fellowship program may have dual intent, i.e. intent to immigrate temporarily and permanently. Current law requires J-1 visa applicants to establish substantial ties to their home country and no intent to immigrate to the U.S. permanently.
- Creation of Cap-Gap Work Authorization for H-1B Cap-Exempt Physicians. Doctors who would lose their visa status due to the timing gap between when they finish their training in cap-exempt H-1B status and when they are able to obtain a cap-subject H-1B visa, will maintain their status until October 1. If physician does not win a capped H-1B visa, his work authorization would be extended for October 1 of the next year so that he may re-apply for the capped H-1B visa at that time.
Of course, it is unknown if and when the bill will become law. If you support the proposed changes in the bill, call, write, or email your congressional representative to urge approval of the bill. Visit www.senate.gov and www.house.gov for contact information.
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